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Observational Study
. 2024 Feb 1;24(1):84.
doi: 10.1186/s12872-024-03752-y.

Wellens Syndrome: prevalence, risk factors and coronary angiographic variation. A cross-sectional study

Sami Mohamed  1 , Samoal Abdelaziz  2
Affiliations
Observational Study

Wellens Syndrome: prevalence, risk factors and coronary angiographic variation. A cross-sectional study

Sami Mohamed et al. BMC Cardiovasc Disord. .

Abstract

Background: Wellens syndrome complicates acute coronary syndrome and, if unmanaged, can lead to immanent myocardial infarction. This study aimed towards determining the prevalence of Wellens syndrome among acute coronary syndrome patients while focusing on both types and identifying the associated risk factors, then exploring the variation in affected coronary arteries within patients fulfilling Wellens syndrome criteria.

Methods: Implementing a descriptive cross sectional hospital based observational study design, at Ahmed Gasim Teaching Hospital for Cardiac Surgery and Renal Transplantation in Khartoum North, Sudan, the study was conducted following using a non probability convenience sampling of patients fitting the inclusion criteria. Data was collected using closed ended structured questionnaires. Ethical clearance was obtained from relevant authorities. Statistical analysis was done using descriptive and comparative data analysis with the aid of the SPSS software, and STROBE guidelines were followed.

Results: A total of 120 patients were included, 70 males and 50 females, majority in their fifth decade. 14 patients had no documented risk factors. 42.5% had STEMI, 34.2% had NSTEMI and 23.3% had unstable angina. Patients fulfilling Wellens syndrome criteria were 18 (15%), 55.6% of them were type A and 44.4% were type B. Most frequently encountered risk factor among Wellens syndrome patients was Diabetes (50%). Out of 16 Wellens syndrome patients who underwent coronary angiography, 50% had mid LAD involvement, most were type A; 25% had proximal LAD involvement and 25% had normal coronary angiography. There was some association between Wellens syndrome and NSTEMI, but no significant association with any specific risk factor.

Conclusion: Wellens syndrome complicates 15% of acute coronary syndrome patients with a 55.6% possibility of becoming type A, it can present even without a specific predisposing risk factor and coronary angiographic variation other than the proximal part of the LAD artery may occur, including multiple vessels involvement. This is a descriptive cross sectional study conducted at Ahmed Gasim Teaching Hospital in Sudan, to determine the prevalence and risk factors of Wellens syndrome. Data was collected using questionnaires and analyzed with the SPSS software. Out of 120 patients, 14 patients had no documented risk factors. 34.2% had NSTEMI and 23.3% had unstable angina. Patients fulfilling Wellens syndrome criteria were 18 (15%). The commonest risk factor among Wellens syndrome patients was Diabetes (50%). 50% of Wellens syndrome patients had mid LAD involvement. The study concluded that Wellens syndrome is not rare, it can present without specific risk factor and coronary angiographic variation other than the proximal LAD artery can occur.

Keywords: Acute coronary Syndrome; Biphasic t wave; Coronary angiography; NSTEMI; Proximal LAD; Wellens Syndrome.

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Conflict of interest statement

None.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
ECG patterns showing criteria and types of Wellens syndrome
Fig. 2
Fig. 2
Flow diagram of patients’ pathway throughout the course of the study
See this image and copyright information in PMC

References

    1. de Zwaan C, Bär FW, Wellens HJ. Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Am Heart J. 1982;103(4 Pt 2):730–736. doi: 10.1016/0002-8703(82)90480-x. - DOI - PubMed
    1. de Zwaan C, Bär FW, Janssen JH, Cheriex EC, Dassen WR, Brugada P, Penn OC, Wellens HJ. Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Am Heart J. 1989;117(3):657–665. doi: 10.1016/0002-8703(89)90742-4. - DOI - PubMed
    1. Kobayashi A, Misumida N, Kanei Y, Fox J. CRT-111 prevalence and prognostic value of Wellens’ sign in patients with non-ST elevation myocardial infarction. JACC: Cardiovasc Inter. 2015;8(2):S11–S12. doi: 10.1016/j.jcin.2014.12.041. - DOI
    1. Akhtar P, Rizvi SN, Tahir F, Saleem D, Mulla J, Saghir T. Angiocardiographic findings in patients with biphasic T-wave inversion in precordial leads. J Pak Med Assoc. 2012;62(6):548–551. - PubMed
    1. Sheng FQ, He MR, Zhang ML, Shen GY. Wellens syndrome caused by spasm of the proximal left anterior descending coronary artery. J Electrocardiol. 2015;48(3):423–425. doi: 10.1016/j.jelectrocard.2015.03.009. - DOI - PubMed

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